Call to Action: Vaccine Equity in Israel-Palestine

By Asmaa Rimawi, Anand Chukka, and Lianet Vazquez

We are students at Harvard Medical School concerned about the state of health in the Palestinian territories, currently exacerbated by the COVID-19 pandemic and Israel’s inequitable distribution of vaccines. This letter is in direct response to claims by faculty at our medical school, American public health professionals, and the mainstream media that Israel’s vaccination campaign is a successful example of COVID vaccine distribution.

This positive portrayal of Israel’s vaccination campaign is misleading. While Israel has vaccinated 49% of its citizens, five million Palestinians who live under Israel military occupation or blockade have not been included in its vaccination campaign and will have to wait months for vaccines (1) . Physicians for Human Rights-Israel, along with 14 other Israeli, Palestinian, and international health and human rights organizations have called on Israel to provide the necessary vaccines to Palestinian healthcare systems (2).

Under the 4th Geneva Convention and international human rights law, Israel is obligated to provide healthcare and meet sufficient public health standards in the occupied territories. The Israeli government has claimed that vaccination responsibilities fall with the Palestinian Authority (PA), the limited self-governing body, as part of a 5-year interim agreement (3). The PA, however, maintains only limited rule of certain parts of the West Bank and is dependent on international humanitarian aid, as well as tax revenue collected by Israel on its behalf. Israel maintains full civilian and military control of 61% of the West Bank, where Israeli settlers, who enjoy full civil liberties and rights under Israeli law, are receiving COVID vaccines transported by specialized, refrigerator-equipped vans. Their Palestinian neighbors living a few kilometers away under Israeli military rule have not received these COVID vaccines by virtue of being Palestinian. Amnesty International has declared that these vaccine disparities add to the mounting evidence of Israel’s institutionalized discrimination (4).

The devastation resulting from the COVID-19 pandemic and the ensuing disparities in pandemic response and vaccine distribution has been exacerbated in the Gaza Strip, the densely populated territory administered by the Palestinian Authority that has been under Israeli and Egyptian land and sea blockade for the past 13 years. Since then, Israel has waged three large-scale military campaigns that have left the territory’s healthcare infrastructure in shambles, with rebuilding efforts limited by the blockade. Electricity cuts have prevented Gaza’s ICUs from caring for COVID patients and others and would make storing a vaccine difficult if it were available. The continual gutting of Gaza’s healthcare system has resulted in a surge in COVID cases with limited testing capabilities and ICU beds (4). In addition to refusing to vaccinate civilians within Gaza, Israel has also directly blocked the entry of 2,000 vaccines acquired by the Palestinian Authority for front-line healthcare workers in Gaza (5). By virtue of its 13-year blockade of the Gaza Strip, and the subsequent devastation of the territory’s healthcare infrastructure, Israel is obligated to make vaccines available to Palestinians in the strip and to assist them in their pandemic response.

In our time at Harvard Medical School, we have been taught that a healthcare system that purposely prioritizes citizens based on race, religion, or ethnicity cannot be deemed a successful healthcare model, and that metrics such as equity are critical in assessing a healthcare system. Given the devastation that this pandemic has wrought on Palestinian communities living under Israeli military occupation or blockade, and Israel’s failure to meet its responsibilities as an occupying power under international law, we call our own medical school and others to stand in solidarity with the Palestinian people by demanding that Israel equitably distribute its supplies of the COVID-19 vaccine. We reiterate the following articulated asks of Israel made in a joint statement by human rights organizations in Israel-Palestine(6):

Provide a quantity and timeline of vaccines for the Palestinian people
Ensure that the vaccines that are distributed are of equal quality and standardization as those given to Israeli citizens and Israeli settlers of the West Bank.
Provide and ensure a ‘cold chain’ infrastructure is set-up to allow for sustainable delivery of the COVID-19 vaccine
Provide full financial support of the Palestinian Authority’s initiative to distribute the COVID-19 vaccine
End the blockade and occupation of the Palestinian Territories and work to rebuild previously damaged healthcare infrastructure.